title: Refractory enuresis related to alarm therapy.
abstract: OBJECTIVE
  To clarify refractory enuresis related to alarm therapy, we evaluated the possibility of the prediction of refractory cases, the effectiveness of alarm therapy for cases refractory to pharmacotherapy and the prognosis of non-responders to alarm therapy.
  
  
  METHODS
  First, the effectiveness of alarm therapy in 55 monosymptomatic patients and 29 with daytime symptoms was evaluated. Next, another 37 patients with monosymptomatic nocturnal enuresis were treated by enuresis alarm. Possible predictive factors of therapeutic effect were compared between the 'effective' patients and the 'no-change' patients. The effectiveness of alarm monotherapy for non-responders to pharmacotherapy was evaluated. The prognosis of non-responders to alarm therapy at 6 months was also studied.
  
  
  RESULTS
  In the 55 monosymptomatic patients, the total effective rate at 3 months was 59%, while that in the 29 patients with daytime symptoms was only 38%. In the 37 patients with monosymptomatic nocturnal enuresis, there were no significant differences between the effective patients and the no-change patients in possible predictive factors. Even in patients who had previously had pharmacotherapy, the effective rate of alarm therapy was 64%, while it was 57% in patients without previous therapy. The effective rates of DDAVP and imipramine for non-responders to alarm monotherapy were only 25% and 33%, respectively.
  
  
  CONCLUSIONS
  Daytime symptoms were the only predictive factor of alarm therapy. Alarm therapy was effective for cases refractory to pharmacotherapy. Non-responders to alarm therapy were also refractory to pharmacotherapy.
authors.affiliation: Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan. kawauchi@koto.kpu-m.ac.jp
authors.forename: Akihiro
authors.initials: A
authors.lastname: Kawauchi
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Naitoh
authors.forename: Kimihiko
authors.initials: K
authors.lastname: Yoneda
authors.forename: Jintetsu
authors.initials: J
authors.lastname: Soh
authors.forename: Hideo
authors.initials: H
authors.lastname: Seki
authors.forename: Koji
authors.initials: K
authors.lastname: Okihara
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Mizutani
authors.forename: Tsuneharu
authors.initials: T
authors.lastname: Miki